Salt Lake City Autorama

South Towne Expo Center - March 5, 2010

Mail completed order form and check, or fax form and credit card information to:
Championship Auto Shows, Inc., 1092 Centre Rd., Auburn Hills, MI 48326
FAX (248) 373-7091 Attn: Student Day

QTY	Description	Price (each)
	Student / Chaperone With Lunch	$15.00
	Student / Chaperone W/out Lunch	$10.00
	Bus Parking – No Charge	$0
		TOTAL

Name of School
Address
City
State / Prov.		Zip
Contact Name		Phone Number
Contact Email

PAYMENT INFORMATION (no refunds)
Check (enclosed)

Credit Card
Card Number	3 Digit Security Code
Expiration Date	of
Billing Name
Billing Address
Billing City
Billing State
Billing Zip Code

SIGNATURE	____________________________________________________________________________

Additional questions, please call:
(248) 373-1700